The short answer. Two very different approaches are being tested. Islet cells grown from stem cells, infused to replace the insulin-producing cells, made most patients in one trial insulin-independent at one year. But they require lifelong immunosuppression, are given only in specialist trial centres, and are not yet approved. Mesenchymal stem cell (MSC) infusions soon after diagnosis slowed the loss of the body’s own insulin production in a small trial, but no one became insulin-independent. Neither is a treatment you can buy at a clinic today, and you must never stop insulin.
Stem cell treatment for type 1 diabetes is offered only as an adjunct: alongside insulin, your diabetes team’s care and a healthy lifestyle, never instead of them. Islet replacement is currently available only within clinical trials, and the evidence for MSCs is still developing.
Why type 1 diabetes is a target for stem cell research
In type 1 diabetes, the immune system destroys the beta cells in the pancreas that make insulin. So there are two problems to solve: replacing the lost cells, and stopping the immune system from destroying them again.
The only approved treatment that acts on the immune process so far is an antibody, teplizumab, which delayed the diagnosis of type 1 diabetes by a median of about two years in high-risk relatives.1 Everything else on this page is still in trials.
Two very different approaches
| Stem-cell-derived islets | MSC infusion | |
|---|---|---|
| What it is | Insulin-producing islet cells grown in the laboratory from stem cells, infused to replace the cells that were lost. | Mesenchymal stem cells given by drip to calm the immune attack on the remaining beta cells. |
| Who it is for | People with long-standing type 1 diabetes and severe low blood sugar episodes, in trials. | People diagnosed recently who still make some insulin, in trials. |
| Best result so far | 10 of 12 patients off insulin at one year.2 | Slower loss of the body’s own insulin; no one off insulin.5 |
| Main drawback | Lifelong immunosuppression, with its risks. | Benefit is modest and unproven in larger trials. |
Replacing the cells: stem-cell-derived islets
This is the real breakthrough. In a trial published in 2025, 12 adults with long-standing type 1 diabetes and dangerous low blood sugar episodes received a single infusion of laboratory-grown islet cells (zimislecel) into the liver. All 12 began making their own insulin again. At one year, 10 of the 12 no longer needed insulin injections, all had an HbA1c below 7%, and none had a severe low blood sugar episode.2
The cost is lifelong immunosuppression to stop the body rejecting the cells. One participant died of a brain infection judged to be related to the immunosuppressive drugs, and another died of progression of a dementia that existed before the trial.2 The treatment is now in a phase 3 trial. As of August 2026, the company was still enrolling and treating patients in that trial and had not announced a date to apply for approval.3 It is not yet an approved treatment, and access is through clinical trials only.
Researchers are also trying to avoid immunosuppression altogether. In 2025, a single man received donor islet cells genetically engineered to hide from the immune system, injected into his forearm muscle with no immunosuppressive drugs. The cells survived and made insulin for at least six months.4 It was a low dose, he still needed insulin, and it was one patient, but it points to where the field is going.
Protecting the cells you still have: MSC infusions
Soon after diagnosis, most people still make some insulin. In a randomised, placebo-controlled trial in Sweden, 15 adults diagnosed within the previous two years received donor umbilical cord MSCs or placebo. Over a year, the placebo group lost a median of about 47% of their own insulin production; the MSC group lost about 10%, and their insulin dose stayed stable. No one became insulin-independent, and HbA1c did not differ. No serious side effects were linked to the cells.5
It is an encouraging but very small trial, and the treated group started with slightly higher insulin production. Larger trials are needed. MSCs have not been shown to restore insulin production in people with long-standing type 1 diabetes who no longer make any.
Recently diagnosed with type 1 diabetes?
If you would like to understand the research options honestly, including clinical trials, bring your diagnosis date and your C-peptide result if you have one.
Before any stem cell treatment: the whole picture
With type 1 diabetes, as with any autoimmune condition, I do not move straight to stem cells. Before anything is planned, I look at the whole picture:
- Your current main treatment: what you take, how well it is working, and whether it has been optimised.
- A second or third opinion where it would help. Sometimes the most useful thing I can do is refer you back to a endocrinologist or diabetes team to review your main treatment plan.
- Other conditions that can contribute to autoimmune activity, such as other autoimmune diseases, thyroid problems, low vitamin D or ongoing infections.
- Your lifestyle: how stressful your life is, your sleep, diet, activity and smoking.
Regenerative treatment, if it is appropriate at all, is one part of that plan, not the whole of it.
What about exosomes?
Exosomes have not been tested in controlled trials in people with type 1 diabetes. Any claim that they can restore insulin production is unsupported.
Never stop insulin
People with type 1 diabetes die without insulin. No stem cell or exosome treatment available outside a clinical trial replaces it. Be very wary of any clinic, in any country, that promises to cure type 1 diabetes or to take you off insulin. The treatments that have done this in trials require specialist transplant centres and immunosuppression, and they are not available as a clinic procedure.
How would we know whether something helped?
- C-peptide, ideally after a standard meal test, which shows how much insulin your own body still makes.
- HbA1c and time in range on your glucose sensor.
- Your daily insulin dose, and episodes of low blood sugar.
Any change to your insulin dose is made with your diabetes team, based on these measurements.
Is MSC treatment safe?
Across 55 randomised trials and 2,696 patients in other conditions, the only side effect clearly linked to MSC drips was a short-lived fever. The pooled analysis did not detect an increased rate of infection, thrombotic events or malignancy during the available follow-up.6 That does not exclude rare or long-term risks.
At our clinic, cells and exosomes are prepared by two established, regulated laboratories: one Italian, operating since 2009 and in Dubai since 2013, and one British, in Dubai since 2017. Every patient is screened and assessed before treatment.
Frequently asked questions
Can stem cells cure type 1 diabetes?
Not yet. Stem-cell-derived islets made most patients in one trial insulin-independent,2 but they require lifelong immunosuppression and are not yet approved.
Is zimislecel available in Dubai?
Not as an approved treatment. It is available only through clinical trials, and as of August 2026 the company had not announced a date to apply for approval.3
I have had type 1 diabetes for 20 years. Can MSCs help me?
MSCs have not been shown to restore insulin production once it has been lost. The research in MSCs focuses on people diagnosed recently.5
Can I stop insulin after stem cell treatment?
Only within a supervised trial, and only when your diabetes team confirms it from your blood tests. Never stop insulin on your own.
Do exosomes help type 1 diabetes?
They have not been tested in controlled trials in people with type 1 diabetes.
Book a consultation.
An honest conversation about the research, with your diabetes team kept involved.
This article is patient education and does not replace the advice of your endocrinologist or diabetes team.
References
- Herold KC, Bundy BN, Long SA, et al. An anti-CD3 antibody, teplizumab, in relatives at risk for type 1 diabetes. N Engl J Med. 2019;381(7):603–613. doi:10.1056/NEJMoa1902226
- Reichman TW, Markmann JF, Odorico J, et al. Stem cell–derived, fully differentiated islets for type 1 diabetes. N Engl J Med. 2025. doi:10.1056/NEJMoa2506549
- Vertex Pharmaceuticals. Vertex reports second quarter 2026 financial results. 3 August 2026. news.vrtx.com
- Carlsson PO, et al. Survival of transplanted allogeneic beta cells with no immunosuppression. N Engl J Med. 2025. doi:10.1056/NEJMoa2503822
- Carlsson PO, Espes D, Sisay S, et al. Umbilical cord-derived mesenchymal stromal cells preserve endogenous insulin production in type 1 diabetes: a phase I/II randomised double-blind placebo-controlled trial. Diabetologia. 2023;66(8):1431–1441. doi:10.1007/s00125-023-05934-3
- Thompson M, et al. Cell therapy with intravascular administration of mesenchymal stromal cells continues to appear safe: an updated systematic review and meta-analysis. EClinicalMedicine. 2020;19:100249. doi:10.1016/j.eclinm.2019.100249
This article is part of my guide to regenerative medicine in Dubai. If you are considering treatment, read how I assess stem cell therapy in Dubai.
